HIV Prevention in High Risk Drug Use Sites: Project RAP

描述（由申请人提供）：这四年的纵向前瞻性 研究将利用关于吸毒者社交网络和吸毒网站调查结果， 对活跃的吸毒者及其网络进行同伴主导的干预， 在他们聚集吸毒的地方进行。该项目是基于一个 艾滋病毒预防高危吸毒环境研究（P01 MH/DA 5 6826， 项目#3）。这项名为“高危药物中的艾滋病毒预防”的新研究的目的是， 使用地点：项目RAP（风险规避伙伴关系）”是：1）开发和 在高风险吸毒场所实施干预方案， 将接触研究中心用户及其风险网络的同伴健康倡导者（PHA） 与艾滋病毒预防信息，材料和示范做法; 2）评估 这种基于站点的同伴干预计划降低艾滋病毒风险的有效性， 增加吸毒者及其风险网络的保护行为 3）记录干预信息和材料的传播， PHA进入场所并通过与之相关的吸毒网络; 4） 描述有效PHA的特征和网络关系， 成功地使艾滋病毒预防做法在 他们的网络联系人;以及5）启动并记录 与吸毒者领导的社区宣传小组有关的活动， 作为自己组织和动员的工具， 群体确定的健康问题和影响高危吸毒者的其他问题。 我们将招募和培训120名活跃的吸毒者， 针对其吸毒网络成员和性别设计的预防干预措施 伙伴PHA培训将包括5节课程， 公共卫生机构在现场宣传干预措施的会议， 与项目工作人员合作。PHA将参考项目360网络 他们将提供干预的成员（联系推荐人-CR），以及 我们将评估干预接触的数量和类型、影响， 长期影响。我们还将对750名吸毒者进行一次“社区调查”， 第四年的用户评估预防信息/材料的传播情况 通过哈特福德的吸毒网络本研究采用PHAs面板设计 和CR来衡量风险行为的变化和预防措施的采用 实践随时间的变化（基线、6个月随访、第4年调查）。的 全社区调查还可以分析干预措施的效果， 更广泛的吸毒者网络。数据收集方法包括结构化 调查和过程跟踪，以及半结构化访谈， 人种学观察，记录项目活动和对进程的影响 成果评价分析。

DESCRIPTION (provided by applicant): this four-year longitudinal prospective study will utilize findings on drug-user social networks and drug use sites to test a peer-led intervention with active drug users and their networks, conducted in the places they gather to use drugs. The project is based on a study of high-risk drug use settings for HIV prevention (P01 MH/DA5 6826, Project #3). Aims of the new study, entitled "HIV Prevention in High-Risk Drug Use Sites: Project RAP (Risk Avoidance Partnership)" are to: 1) develop and implement in high-risk drug-use sites an intervention program using trained Peer Health Advocates (PHAs) who will reach site users and their risk networks with HIV prevention messages, materials, and model practices; 2) evaluate the efficacy of this site-based peer intervention program for reducing HIV risk and increasing protective behaviors among drug users and their risk network members; 3) document the diffusion of intervention messages and materials by PHAs into sites and through the drug-using networks associated with them; 4) describe the characteristics and network relationships of effective PHAs who successfully bring about long-term adoption of HIV prevention practices among their network contacts; and 5) initiate and document the development process of and activities associated with a drug-user-led Community Advocacy Group, as a vehicle for their own organization and mobilization to advocate for group-identified health concerns and other issues affecting drug users at risk. We will recruit and train 120 active drug users to conduct a specifically designed prevention intervention with their drug-using network members and sex partners. PHA training will include a 5-session curriculum followed by 5 sessions in which the PHA disseminates the intervention in the field in partnership with project staff. PHAs will refer into the project 360 network members (Contact Referrals-CRs) to whom they will provide intervention, and whom we will assess for number and type of intervention contacts, impact, and long-term effects. We also will conduct a "community-wide survey" with 750 drug users in year 4 to assess the diffusion of prevention messages/materials through Hartford drug-using networks. This study uses a panel design with PHAs and CRs to measure changes in risk behaviors and adoption of prevention practices over time (baseline, 6-month follow-up, year-4 survey). The community-wide survey additionally allows analysis of intervention effects in the broader networks of drug users. Data collection methods include structured surveys and process tracking, as well as semi-structured interviews and ethnographic observation to document project activities and effects for process and outcome evaluation analyses.